Associations between neurodevelopmental traits and perinatal depression: a prospective study in Japanese women

Abstract Purpose This study examined how attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) traits relate to depressive symptoms from late pregnancy through early postpartum in Japanese women, alongside perinatal factors. Methods In a multicenter prospective study, 1,104 women completed questionnaires at late pregnancy (T1), 2 weeks postpartum (T2), and 1 month postpartum (T3). Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), ADHD traits with the Adult ADHD Self-Report Scale (ASRS), and ASD traits with the Autism Spectrum Quotient (AQ). Chi-square tests evaluated timepoint-specific associations, multivariable logistic regression identified independent predictors of EPDS positivity at T2, and a linear mixed-effects model assessed longitudinal changes. Results EPDS scores and EPDS positivity were highest at T1 and declined postpartum (16.7%, 8.6%, 4.0%). Scores were correlated across timepoints. In univariate analyses, antenatal EPDS positivity showed associations with ASD traits (AQ+: OR = 6.08, 95% CI 2.17–16.99) and ADHD traits (ASRS+: OR = 4.86, 95% CI 3.06–7.72). In multivariable analysis, independent predictors of EPDS positivity at T2 included ADHD traits (OR = 1.37, 95% CI 1.13–1.66), primiparity, psychiatric treatment history, and antenatal EPDS scores. ASD traits were not associated with T2 EPDS positivity after adjustment for antenatal EPDS scores. In the mixed-effects model, both ADHD and ASD traits were associated with higher EPDS scores during pregnancy, with attenuated effects postpartum. Conclusion Neurodevelopmental traits are associated with perinatal mental health, and trait- and timing-informed support may enhance maternal psychological stability and caregiving outcomes.